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* On Monday, the governor issued a warning to some nursing home owners and managers…
I briefly want to address concerns about long term care facilities not adhering to proper COVID-19 response protocols. Thus far facilities seemed to have been responsive to IDPH guidance and compliance with IDPH teams on the ground. Just like our other health care workers staff at these facilities, our frontline workers dedicating their days and nights to caring for seniors and doing all that they can to ensure a safe and healthy home for their residents. We as a state are deeply grateful for their service.
That said, we will not hesitate to hold any bad actors at the management level accountable. These private facilities are home to some of our most vulnerable Illinoisans, and we expect owners and managers responsible for their care to take every action at their disposal to keep them safe.
The governor’s remarks clearly struck a nerve.
* A reporter asked the governor this question yesterday…
How do you respond to concerns from nursing home groups that their facilities were not prioritized soon enough by the administration, including testing and PPE? They argue that this has led to even worse shortages of PPE and more positive cases and facilities as many cases went undiagnosed for limited access to testing
Part of the governor’s response…
Who is it that made the, not the question, but made the statement about PPE not being real? I think it’s an association. […]
I don’t think it would be fair to say that we have not provided PPE to nursing homes or to the counties to provide to their nursing homes. But we certainly want to know when there are nursing homes where you believe there is not PPE being made available every day to the people in those nursing homes where there are COVID positive patients, you should let our IDPH know. Dr. Ezike and her staff are all over this and they want to make sure that every one of our seniors is protected.
* A little background. I received this email after Monday’s media briefing from Matt Hartman, the executive director of the Illinois Health Care Association…
Rich, there was a good deal of misinformation in the Governor’s presser today in regards to nursing homes and how the state has handled the impact of the COVID-19 crisis in regards to the sector. The statements regarding expansive testing in facilities, prioritization of the sector for PPE, and prior statements about additional funding for nursing homes flowing all mischaracterized the reality. The timelines they describe are inaccurate, as are the responses to the requests of the sector and how they have involved us.
Testing in broad strokes in nursing homes didn’t begin until this week, prior to that centers had to request tests on a case by case basis, and in spite of the increased threat the virus poses to our residents, they were frequently denied. Nursing homes were not included on the initial priority list for PPE, rather they were told to individually request of their local health departments to be included, by which point the initial supplies were depleted. No funding has gone to facilities for the wildly increased costs of PPE and staffing during the crisis, though increases have been discussed by HFS.
* So, I asked the administration for a response. It came in not long before yesterday’s daily press conference and I didn’t have enough time to put something together. From deputy comms director Jason Rubin…
Hey Rich,
If the Illinois Health Care Association has concerns about the Governor’s statements we recommend they reach out to us directly so we can clarify. We have provided Matt and his team with a multitude of channels through which we can share information, guidance, and concerns during this pandemic. In fact, Deputy Governor Sol Flores and her team have a call with Matt and his team later this afternoon, one of the many calls that now take place every week, and I know they’re looking forward to another productive conversation.
On the substance, I would strongly encourage the association give the Governor’s remarks another listen before claiming the Governor is mischaracterizing reality. On testing, the Governor clearly laid out the fact that we have been able to secure more testing supplies, like VTM and swabs, and are therefore now able to more aggressively deploy testing at our long term care facilities. In facilities with known cases, we will continue to operate under the assumption that residents showing symptoms have COVID-19 and should be isolated and treated accordingly, but we will more aggressively test staff to understand who can safely continue working and who should isolate. In facilities without cases, we will test both residents and staff to isolate cases before widespread transmission. The Governor made clear in his remarks that we tested our first two homes over the weekend and an additional ten facilities yesterday. I’m not sure what was unclear about that timeline for Matt, but I’m sure the Deputy Governor and her team can help clear up any confusion this afternoon.
On PPE, everyone has to request PPE from their local health departments and county emergency management agencies. Those requests are all filled at the local level and when local stockpiles are depleted, county emergency management agencies make requests for additional PPE from IEMA. The state has made clear to local health departments that long term care facilities should be made a priority along with health care workers and first responders, who engage in this same process. If the association is suggesting long term care facilities be provided with a separate process than hospital workers and first responders, they are welcome to raise that on the call this afternoon.
On funding, as Matt Knows, Nursing Homes received initial funding from the CARES Act and will likely receive additional funding as soon as the federal government issues guidance. In the meantime, the state has provided a rate increase for nursing homes providing COVID-19 positive only care and we have streamlined the process for eligibility and admissions approvals to bring additional funding into all nursing homes at this time. This is in addition to the $240 million increase in funding the industry received less than a year ago, which represented a 10% rate increase.
Long term care facilities care for some of our most vulnerable residents. As the governor said, we are deeply grateful to the staff at these facilities who are on the frontlines, dedicating their days and nights to keeping our seniors safe. We look forward to continued dialogue with the Illinois Health Care Association as to how best we can all support that critical work.
posted by Rich Miller
Wednesday, Apr 22, 20 @ 10:09 am
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“On PPE, everyone has to request PPE from their local health departments and county emergency management agencies. Those requests are all filled at the local level and when local stockpiles are depleted, county emergency management agencies make requests for additional PPE from IEMA”
Yup. They can’t create a separate process where the state directly sends PPE to nursing homes around the state, bypassing the established supply chains for the local health departments. The logistics would be a disaster.
Comment by NIU Grad Wednesday, Apr 22, 20 @ 10:19 am
Rubin’s unintentional big reveal is the political heft of nursing homes pushing aside the interests of other groups also hip-deep in the COVID crisis, too. Messages to Flores and her office from groups w/o PACs and deep-pocket donors go unanswered. Requested increases, for example, for behavioral health, ignored. But for nursing homes - boom - conference calls w/ Flores and rate increases. Got it. Thanks, Jason!
Comment by King Louis XVI Wednesday, Apr 22, 20 @ 10:49 am
What’s exciting about all of this is that suddenly these private (and in some case for profit) companies are trying to shift blame from their failure to be prepared for a foreseeable outbreak of an infectious disease in their individual facilities.
COVID-19 is a different animal, but what exactly was their plan for any infectious disease pandemic or even for an especially bad flu season?
Their effort to shift culpability from their unsafe facilities, unsafe working conditions, and absolute failure to be able to provide PPE or maintain adequate inventories of PPE to provide it for their staff and patients is something that should be discussed.
This is their business. This is their industry. This is their failure.
I’m glad that we — as in our governments — are doing everything we can to help, but it seems like these entities didn’t do much to help themselves before the crisis and perhaps we should be discussing policy changes in how these facilities are owned and operated in order to make sure that in the future staff won’t be threatened with termination for wearing PPE when some penny pinching profiteering healthcare bureaucrat has created their own shortage.
The government is involved in this because of their failures as a private sector entity to provide for themselves. We cannot let them forget that.
Comment by Candy Dogood Wednesday, Apr 22, 20 @ 10:50 am
The governor’s emergency order granting tort immunity to hospitals and health care workers who treat coronavirus patients does not extend to all nursing homes and retirement facilities. I think that might be fueling this dispute.
Comment by TNR Wednesday, Apr 22, 20 @ 10:54 am
The industry has a long history of absolutely horrible infection control practices. Jamming three or four people into a modest sized room and giving them all prophylactic antibiotics is not infection control.
Hospitals are short on PPE because they go through it quickly, especially with the influx of new patients and rapid turnover of patients.
Nursing homes have not had that rapid influx nor patient turnover. Did they even have a complete stock of PPE in the first place, in anticipation of the seasonal flu? Apparently not.
It’s not a question of the State’s priorities, it’s their own priorities — profit! (And don’t let the label - non-for-profit - fool you. Most of those so-called not-for-profits, other than the religious-affiliated homes, are phony non-profits, set up by private companies who then make money off the homes as management companies, suppliers, etc.)
Comment by Rasselas Wednesday, Apr 22, 20 @ 11:01 am
===I think that might be fueling this dispute. ===
Potentially, but hospitals and providers are in a different situation than a long term care or rehabilitation facility.
I think our solution to our problem here can be well met by examining what occurs with nursing homes in Canada, Britain, Germany, France, etc.
This pandemic has demonstrated where we are woefully inadequate in our ability to meet a public health crisis, and it’s very clear across the country that our nursing home and similar facilities are not prepared for this.
I keep thinking of the viral photo of those nurses without PPE transporting infected patients out of the nursing home in Washington holding up bed sheets.
If private management is unwilling to spare an expense to be prepared, private management should end. Especially as we hear from a head of a lobbying organization that is getting paid out of revenues from nursing homes who literally represents waste in a system intended to provide skilled nursing care.
Comment by Candy Dogood Wednesday, Apr 22, 20 @ 11:03 am
Some private retirement homes and nursing facilities were late, late, late in taking COVID-19 seriously. I may have mentioned here a retirement home that was a polling place on March 17, a decision that by turns horrifies me and seems unreal. I also know of a nursing facility that did not require PPE for anyone but nursing staff until quite recently, and lackadaisical enforcement at that. They’ve also been operating on the assumption that COVID is the least likely cause of anyone’s fever.
Mandatory testing is a step in the right direction, but I fear the results will be devastating across the state.
Comment by yinn Wednesday, Apr 22, 20 @ 11:27 am
Much hypocrisy here? The State from day one was crying to the Federal government for PPE and medical supplies because they didn’t have a stockpile of their own in place let alone a rainy day fund to fall back on. If we want to talk about bad actors lets talk about State government for the last few decades and Michael Madigan and his minions in particular that failed to have the State ready for an outbreak. My spouses employer in this field was very pro-active and unfortunately even with all the precautions they have taken it has lightly occurred in a couple of their facilities. It is happening in our prisons/jails who are the bad actors there, the state, local and federal government I guess. It is happening in homes runs by the government so are they bad actors as well.
Comment by Arock Wednesday, Apr 22, 20 @ 11:45 am
– Most of those so-called not-for-profits, other than the religious-affiliated homes, are phony non-profits, set up by private companies who then make money off the homes as management companies, suppliers, etc. –
Bingo.
Comment by King Louis XVI Wednesday, Apr 22, 20 @ 11:57 am
Wait, Mike Madigan is now responsible for the shortage of PPE?
Is there any problem in the world that these folks can’t find a way to pin on him?
Comment by Juice Wednesday, Apr 22, 20 @ 12:09 pm
The Illinois Democratic party must be very proud, they have managed to politicize a public health emergency that has thus far resulted in the deaths of thousands of Illinois citizens.
Comment by T Wednesday, Apr 22, 20 @ 1:10 pm
What’s missing here is the understanding that the state of IL’s involvement was actually detrimental to the LTC patients and healthcare workers with the highest risk of COVID. Yes, Infection control procedures should already be in place and PPE requirements have not changed for the better since the onset of this public health crisis. However, when the state government took over the supply and distribution of PPE in March, it had IDPH redirect and take receipt of all suppliers longstanding PPE orders that were supposed to go to LTC facilities across the state for infection control and patient / employee protection. IDPH redirected not just PPE, but also test swabs, prioritizing delivery to hospitals above LTC facilities and providers. This situation made it impossible to get expected PPE and swab scheduled deliveries. So in trying to secure PPE in this environment, for healthcare workers outside of hospital systems, the only way was to reach out to IDPH and local health departments. If you’ve ever been to the DMV you know what this can be like. Local health departments directed PPE requests to IDPH, who then directed you back to the local health departments. Some requests were finally addressed in minimal quantities but the shortages are still a problem. Voicing support for the LTC facilities without giving them the PPE and test swabs to do widespread testing at positive facilities is not enough.
Comment by GFK Wednesday, Apr 22, 20 @ 1:48 pm
Early on in the crisis we had already put policies in place prior to CDC and IDPH. We was also following IDPH guidance and we started the screening process for all visitors. We had our annual survey at a facility and a surveyor had a low grade temp and a cough. We told them per IDPH guidance she should not be here but we will let her supervisors be the ultimate decision maker. She stayed for the survey that day. Later the facility Administrator was called and my regional team by the regional supervisor and was not very nice to the team. Asking us what we was doing and why. The next day the surveyor came in again with a low grade temp and a cough. IDPH had now put out the form to be completed by visitors. Again we told her to talk to IDPH and her supervisors. She stayed and I was at the facility that day and received the call from the Regional Supervisor and was asked why I was trying to impede his survey. I told him we was following the guidance from IDPH. He said he was not aware of anything etc.. and was not nice to us at all. We started working hard at this when it hit the nursing home in Washington and working on plans, policies etc.. We thought IDPH would have been supportive that we was taking this so serious and not getting onto us. We wanted the survey to continue as much as they did. Thanks and stay safe!
Comment by LTC Provider Wednesday, Apr 22, 20 @ 3:43 pm
It makes no sense — none whatsoever — for nursing homes and hospitals to go through local county public health officials to get pandemic respomse supplies.
Nursing homes are directly licensed and inspected by the Illinois Department of Public Health. If the facilities were not adequately prepared for the pandemic, that is on the agency that licenses them. if they are out of compliance, its in IDPH’s direct interest and responsibility to get them compliant.
This is typical bureaucratic silo within and between agencies. They act as if Director Ezike is not directly responsible for nursing home safety.
As an aside, what’s up with Jason Rubin repeatedly refering to the head of a statewide association as “Matt”? Try “Mr. Hartman”, or better yet, dont personalize it and just refer to the association.
Comment by Thomas Paine Wednesday, Apr 22, 20 @ 9:42 pm
- Juice - Wednesday, Apr 22, 20 @ 12:09 pm: Is the State on solid financial ground going into this pandemic? No it is not. Why? Well a common denominator for the last three and a half decades is the Speaker of the Illinois House that has helped pass bogus balanced budgets and been behind pension holidays or underfunding pensions and retiree healthcare that has left us a debt over $200 billion according to Moody’s. So with this debt I would surmise that the State has not put back money for a rainy day fund or have enough storage of PPE and other medical supplies going into this pandemic. The worship of Michael Madigan that I see from Illinois Democrats is one of the major problems of this State and the corruption in the political system. The corruption road leads back to Madigan whether you want to see it or not.
Comment by Arock Thursday, Apr 23, 20 @ 9:45 am